How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $363.08 Median $3,467.37 Typical High $5,011.87 | Facility | None | $363.08 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $512.86 | Professional | None | $363.08 | $363.08 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,659.59 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $549.54 | Professional | None | $309.03 | $489.78 | $549.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $309.03 Typical High $346.74 | Professional | 62 · Two surgeons | $194.98 | $309.03 | $346.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $77.62 Typical High $100.00 | Professional | 80 · Assistant surgeon | $48.98 | $77.62 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $67.61 Typical High $77.62 | Professional | AS · PA/NP assist | $43.65 | $67.61 | $77.62 |
CareSource Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $645.65 Typical High $2,691.53 | Facility | None | $407.38 | $645.65 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $741.31 | Professional | None | $389.05 | $467.74 | $741.31 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $2,187.76 | Facility | None | $776.25 | $933.25 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $380.19 Median $512.86 Typical High $645.65 | Professional | None | $380.19 | $512.86 | $645.65 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $630.96 | Professional | None | $331.13 | $416.87 | $630.96 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $380.19 | Professional | 54 · Surgery only | $269.15 | $269.15 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $51.29 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $51.29 |
Where Indiana sits
The same service costs 4.4 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Indiana· 32nd of 51
$457
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.